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Indian fathers’ perceptions of young childcare and feeding – A qualitative study
(Academic Press, 2024) Neha Rathi; Sangeeta Kansal; Anthony Worsley
The role of parents in fostering children's healthy habits is a robust area of research. However, most of the existing literature predominantly focuses on mothers' parenting practices. Given the emergence of nuclear, dual earning families and the recent surge in maternal employment in urban India, fathers' engagement in child rearing and feeding warrants attention. The purpose of this research was to document the views of Indian fathers about paternal parenting practices, with an emphasis on children's diet among other health behaviors. Thirty-three fathers of children aged 6–59 months from Kolkata, India took part in semi-structured interviews conducted either face-to-face or over Zoom/telephone in Hindi, Bengali, and English. The interviews were audio recorded, transcribed verbatim, and translated to English. The transcribed data were subjected to thematic analysis informed by the Template Analysis technique. Themes were detected using the NVivo software program. Overall, these Indian fathers played an important role in early childhood care and feeding as reflected in the following seven themes: (i) Involvement of fathers in various childcare activities; (ii) Implementation of responsive and non-responsive feeding practices; (iii) Concerns regarding fussy and slow eating; (iv) Concerns regarding excessive screen time; (v) Paternal vs maternal parenting; (vi) Barriers to routine engagement of fathers in childcare; (vii) Desire for more nutrition and health knowledge. This enhanced understanding of paternal parenting behavior supports the inclusion of fathers in future family-focused lifestyle interventions aimed at improving children's health outcomes, including their dietary habits. © 2024 Elsevier Ltd
Transformation in culinary behaviour during the COVID-19 pandemic: In-depth interviews with food gatekeepers in urban India
(Academic Press, 2022) Lakshmi Menon; Dripta Roy Choudhury; Rimante Ronto; Rupali Sengupta; Sangeeta Kansal; Neha Rathi
COVID-19 and its associated regulatory measures including lockdowns, curfews, and physical distancing norms have significantly affected individual's dietary and culinary behaviours. Although there is ample empirical evidence available on dietary changes within the Indian context, very limited evidence exists about the factors influencing these dietary modifications and changes in culinary behaviours during COVID-19 lockdown. Therefore, the aim of this qualitative study was to explore the views of Indian household food gatekeepers towards meal planning, food purchasing, and meal preparation during the pandemic and its associated lockdowns. A convenience sample of 34 female gatekeepers from the Mumbai metropolis participated in online interviews. Interviews were conducted in English and Hindi (then translated in English), audio-recorded and transcribed verbatim. Underpinned by Template Analysis technique, transcribed data were analysed manually and using the NVivo software program. The interview structure guided the development of themes. The emerging themes included were: Increased household cooking; Involvement of children and male members in food-related activities; Experimentation in the kitchen; Adoption of meal planning skills; Increase in online food shopping; Bulk buying; Shortage of food items; Reduced consumption of outside home food; Increased variety of home-cooked meals; Increase in snacking and overall food intake; Determinants of food choices; and Family meals-a new norm. In the light of these findings, developing family-focussed, web-based nutrition programs to enhance gatekeepers' and their families' food literacy including declarative and procedural nutritional knowledge would be beneficial. The importance of organisational culinary behaviours such as planning meals in advance, shopping with a food list should be promoted to prevent hoarding and subsequently reduce strain on the food supply system. With a surge in domestic cooking, low cost nutritious recipes with the use of local and seasonal produce should be emphasized promoting healthy eating among the gatekeepers and their family members. The inclusion of food studies in the school curriculum will facilitate the development of culinary skills among children and youth. Also, there is a need for further research and surveillance to strengthen understanding of sustainability of healthy culinary behaviours practiced during the pandemic. © 2022 Elsevier Ltd
Perceived influences of fruit and vegetable consumption among Indian adolescents – A qualitative inquiry
(BioMed Central Ltd, 2025) Neha Rathi; Anthony F. Worsley; Meg M. Bruening
Background: Fruits and vegetables are primary sources of vitamins and minerals that may alleviate the risk of chronic illnesses. However, Indian adolescents consume inadequate amounts of fruits and vegetables, with less than 10% meeting recommendations. Micronutrient deficiencies are a major public health problem in India. For example, the prevalence of iron-deficiency anemia and Vitamin A deficiency in adolescents is 28.5% and 14.4%, respectively. To promote fruit and vegetable consumption among Indian adolescents, we need to identify the factors which may influence the consumption. The aim of this qualitative inquiry was to explore perceived influences of fruit and vegetable consumption among Indian adolescents. Methods: Using purposive sampling, adolescents aged 10–19 years were recruited from two public and two private (independent) schools in Varanasi, India. Face-to-face interviews along with the ‘draw and tell’ technique were used for data collection. Interviews were conducted in English as well as in Hindi depending on the preferences of the adolescents. The conversations were digitally recorded and transcribed verbatim. The transcribed data were subjected to thematic analysis. Data were coded inductively, and themes were extracted using NVivo software program. Results: A total of 58 adolescents (53% female; 74% urban) with mean age 13.6 years completed the interviews. Nine major themes and associated sub-themes emerged, including: (i) Sensory properties (i.e., taste, color, flavor, texture); (ii) Health and immunity; (iii) Allergy; (iv) Home food environment (i.e., influence of mothers, availability and accessibility of fruits and vegetables); (v) Cost; (vi) Food preparation; (vii) Influence of peers; (viii) School food environment; (ix) Proclivity for energy-dense, nutrient-poor foods and beverages. Conclusions: The emerging themes and sub-themes show that multiple factors are likely to affect fruit and vegetable consumption in adolescents, aligning with literature on adolescent fruit and vegetable consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage fruit and vegetable consumption in Indian adolescents by removing barriers at the individual, household, and community levels, thereby reducing the enduring prevalence of micronutrient deficiencies. © The Author(s) 2025.
How do adolescents classify foods as healthy and unhealthy?: A qualitative inquiry from rural India
(Cambridge University Press, 2023) Sangeeta Kansal; Aryan Raj; Kumari Smita; Anthony Worsley; Neha Rathi
Indian adolescents exhibit obesogenic dietary habits including low intake of fruits and vegetables and increasing consumption of fast food and carbonated beverages. Adolescents' classification of healthy and unhealthy foods is likely to have significant implications for their dietary behaviour, and consequently, their health. However, there is limited evidence about the ways Indian adolescents classify foods as healthy or unhealthy. Hence, this qualitative study was designed to explore how Indian adolescents classify nutritious or non-nutritious food choices. Convenience sampling was used to recruit the study participants from Tikari village in Uttar Pradesh, India. Underpinned by the social constructivist lens, the adolescents were interviewed face-to-face in Hindi. All the interactions were digitally recorded, transcribed verbatim, and translated into English prior to data analysis. Transcribed data were analysed thematically using inductive as well as deductive coding, and subsequently, conceptual themes were extracted. A total of thirty-nine adolescents (twenty boys; nineteen girls) aged 10-19 years participated in this qualitative inquiry. The adolescents classified healthy and unhealthy foods based on the following six themes: (i) Food groups and nutrients; (ii) Health and immunity; (iii) Type of ingredient; (iv) Place and time of food preparation; (v) Packaging; and (vi) Parental influence. These findings can inform school-based food literacy interventions to foster healthy dietary habits and cooking skills among Indian adolescents. © 2023 The Author(s). Published by Cambridge University Press on behalf of The Nutrition Society.
Indian fathers are involved in nurturing healthy behaviours in adolescents: A qualitative inquiry
(BioMed Central Ltd, 2024) Neha Rathi; Sangeeta Kansal; Anthony Worsley
Background: Indian adolescents exhibit unhealthy food behaviours and inactive lifestyles which increase their risk of developing obesity and associated negative health consequences. The family food environment represents a vital setting to nurture healthy lifestyle behaviours in adolescents, with parents influencing their adolescents’ dietary and physical activity behaviours. Yet, much of the existing evidence exploring parental influences predominantly focuses on mothers while fathers’ engagement in instilling healthy dietary and physical activity behaviours is understudied, more so in the context of developing economies like India. Therefore, this qualitative study was designed to understand Indian fathers’ views on instilling healthy behaviours in their children. Methods: Convenience sampling along with snowball sampling techniques were employed to recruit fathers of adolescents aged 10–19 years from Kolkata city, India. Informed by the research aim and review of literature, an interview guide was developed and pre-tested. Interviews were carried out either in person or virtually (Zoom/telephone) in English/Hindi/Bengali as per the preference of the participants. All interactions were audio recorded, transcribed verbatim, and translated to English for the purpose of data analysis. The transcripts were analysed thematically using NVivo software program. Themes were identified using both inductive and deductive approaches. Results: A total 36 fathers participated in the interviews. Seven main themes were identified: (i) Involvement of fathers in adolescent upbringing (i.e. engagement in meal preparation, food shopping, educational activities, physical activity); (ii) Family food environment (i.e. setting food rules, having meals with children, making food available); (iii) Challenges to instilling healthy behaviours in adolescents (i.e. adolescents’ sedentary lifestyle and liking for unhealthy foods); (iv) Barriers to routine involvement in adolescent upbringing (i.e. time constraints due to paid employment, poor socio-economic status); (v) Adolescent nutrition education: (vi) Dual burden of malnutrition (i.e. awareness of malnutrition, no knowledge about government-led health programs for adolescents); (vii) Paternal knowledge. Conclusions: The emerging themes reveal that Indian fathers played a crucial role in instilling healthy dietary and physical activity behaviour in their adolescents through various parenting practices such as purchasing nutritious food, enforcing food rules, disseminating nutrition-related knowledge, and encouraging adolescents to participate in moderate-to-vigorous intensity outdoor sports. This provides strong support for the inclusion of fathers in sustainable family-focused lifestyle interventions to maximise the nurturing care required by adolescents as well as assist in normalising the representation of fathers in health and welfare policies designed for adolescents. © 2024, The Author(s).
Open gyms and physical activity in a university setting: A mixed-methods study from Varanasi, India
(BioMed Central Ltd, 2025) Lalita Vatta; Upasana Pandey; Anchal Pandey; Bindyashwori Yelam; Neha Rathi
Background: The prevalence of physical inactivity in India is estimated to be 34%; the highest prevalence in South Asian countries. Physical inactivity has increased the risk of non-communicable diseases among urban Indians. Built environment interventions that aim to enhance physical activity have gained popularity in recent years. The construction of outdoor gymnasiums (hereafter referred to as OGs) in green spaces is one such intervention. The installation of OGs on university campuses is a novel concept. The present study was designed to explore the usage of OGs and the perceptions of the users about OGs in a public university setting. Methods: A sequential mixed-methods study design was used to inform this two-fold study. In the first phase (Quantitative), four OGs (i.e. OG-A, OG-B, OG-C, OG-D) were observed between 6.00 am and 8.00 pm for one week per month from December 2022 to March 2023 which corresponds to winter and spring time in Varanasi, India. In the second phase (Qualitative), face-to-face, semi-structured in-depth interviews (N = 66) with a purposive sample of (OG) users were conducted in Hindi. Descriptive statistics and thematic analysis were used to analyze quantitative and qualitative data respectively. Results: Observational data revealed that the OGs were more frequently used during spring as compared to winter. OG-C emerged as the most popular gym across the four-month period as it hosted the highest number of users (N = 3384) followed by OG-D (N = 2380), OG-B (N = 2004), and OG-A (N = 792). Another major observation was that OGs were more likely to be used by males than females. OGs were more crowded over weekends than weekdays. The thematic analysis of qualitative interview data revealed three main themes and associated sub-themes: (i) Perceived benefits associated with the use of OGs (physical and mental health benefits, proximity to nature, opportunity to socialize, safe environment, economical, ease of access for everyone); (ii) Perceived challenges associated with the use of OGs (lack of time, overcrowding, damaged equipment, laziness); (iii) Feedback for improvement of OGs (regular maintenance of gym equipment, installation of more equipment, installation of drinking water stations and restrooms). Conclusions: The emerging findings recognize OGs as viable built environment interventions that encourage people to embrace physical activity. The OGs not only contribute to the revitalization of open green spaces in university campuses where they are installed but also play a significant role towards the fulfilment of social responsibility of educational institutions. © The Author(s) 2025.
Indian adolescents’ perceptions of packaged food and food labels – A qualitative inquiry
(Academic Press, 2023) Sangeeta Kansal; Aryan Raj; Nikitha Pedapanga; Anthony Worsley; Neha Rathi
In the last two decades, India has witnessed a dramatic rise in the consumption of packaged foods, especially among adolescents. Food labelling is often recognised as an instrumental population-based approach which can enable consumers to make informed food choices by providing all the necessary details about the food product on the packaging. In the Indian context, where adolescent obesity and the ensuing non-communicable diseases are escalating, it is crucial to understand adolescents' views on the use of non-nutritious packaged foods and food labels. Therefore, the aim of this qualitative inquiry was to explore Indian adolescents’ perceptions regarding the consumption of packaged food and use of food labels. Convenience sampling was employed to recruit 29 boys and 15 girls (aged 10–19 years) from rural Varanasi, India. Semi-structured, face-to-face interviews were conducted in the local language. Interview recordings were transcribed verbatim and translated to English. Narrative data were subjected to thematic analysis using NVivo software program. The adolescents reported frequent consumption of packaged food like potato chips, biscuits, chocolates, deep-fried Indian snacks both at school and home. Packaged foods were regarded as tasty, safe, and fresh. Brand name, date of expiry and cost were often read by the study respondents. Nevertheless, they reported difficulty in understanding other components of the label (e.g., nutrition information) and they were not aware of the negative impact of consuming unhealthy packaged foods. Nearly all the respondents insisted that food labels should be written in the local language for easy understanding. These emerging findings underscore the need to design school-based food literacy programs for vulnerable Indian adolescents to address obesity and diet-related complications in early adulthood. © 2022 Elsevier Ltd
Indian adolescents' perceptions of anaemia and its preventive measures: Aqualitative study
(Cambridge University Press, 2024) Neha Rathi; Sangeeta Kansal; Aryan Raj; Nikitha Pedapanga; Immanuel Joshua; Anthony Worsley
High prevalence of anaemia is a severe public health problem in several low- and middle-income countries like India. A qualitative inquiry was designed to understand the perceptions of adolescents regarding anaemia and anaemia prevention measures. Convenience sampling was employed to recruit 39 adolescents (19 girls; 20 boys) from Tikari, India. Interviews were carried out in the local language, audio-recorded and transcribed verbatim. Hemoglobin concentration was also assessed from a single drop of capillary blood using the HemoCue, and the participants were asked to share their Science/Biology and Home Science textbooks. Interview data was analysed thematically. Descriptive statistics were used to examine the distributions of the hemoglobin data while textbooks were analysed using content analysis to verify the coverage of anaemia and anaemia-related matter. Seven themes were identified: (i) Poor understanding of the term anaemia; (ii) Minimal discussion about anaemia in classroom; (iii) Limited knowledge about symptoms of anaemia; (iv) Limited awareness about prevention and cure of anaemia; (v) Perception of iron folic acid and deworming tablets among students; (vi) Lack of contribution of health workers in the prevention of anaemia; (vii) No knowledge of 'Anemia free India' programme. More than half of the sample had anaemia (16.7% mild anaemia, 33.3% moderate anaemia, 2.8% severe anaemia). Content analysis revealed that there was limited discussion about anaemia in both Home Science and Science textbooks. Behavioural interventions should focus on inculcating healthy culinary and dietary practices and addressing the gaps in knowledge and understanding of anaemia and its prevention among adolescents. © 2024 The Author(s). Published by Cambridge University Press on behalf of The Nutrition Society.
Recreational Physical Activity in Urban India: Perceptions and a Pilot Intervention
(Cambridge University Press, 2023) Neha Rathi; Renuka Bhandarkar; Mrinmoyi Kulkarni
The inactive lifestyle of urban Indians has increased their risk of non-communicable diseases (NCDs). A qualitative study was designed to explore barriers and facilitators related to exercise participation among urban Indians. Underpinned by the developmental life course theory, nine focus group discussions (FGDs) were conducted with 29 women and 26 men residing in Mumbai, India. Focus groups were gender and age stratified. Both thematic analysis and content analysis techniques were used to analyse the data. While the lack of time was mentioned as a barrier by all groups, an unstructured schedule was mentioned specifically by women and awareness of physical health benefits emerged as the most popular facilitator for recreational physical activity. Based on the results of the FGDs, a pilot exercise intervention for sedentary women (N = 6) was conducted which consisted of a morning walk six days a week for 10 weeks. Post-intervention, an FGD was conducted to explore participants' perspectives on their experience in the intervention. The participants reported that the intervention enhanced exercise self-efficacy and well-being. Exercise as relaxation, spousal support, and need for peers to exercise with emerged as primary themes during the follow-up FGD. These findings can inform the development of age and gender-specific as well as culturally appropriate interventions to facilitate active living. Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Australian Association for Cognitive and Behaviour Therapy.
Factors that influence snacking behaviors among urban Indian adolescents – a qualitative inquiry
(Frontiers Media SA, 2025) Neha Rathi; Anthony F. Worsley; Meg M. Bruening
Background and objectives: Urban Indian adolescents often practice unhealthy dietary behaviors such as meal skipping and snacking on high energy foods with low nutrient value. To promote healthy snacking behaviors among adolescents it is essential to explore the factors that may influence the consumption of healthy and unhealthy snacks among Indian adolescents. Materials and methods: Informed by the social constructivism framework, an exploratory-descriptive qualitative research approach was employed to obtain a richer understanding of the influences on urban Indian adolescents’ snacking behaviors. Using purposive sampling, adolescents aged 10–19 years were recruited from two government and two private schools in Varanasi city, Uttar Pradesh, India. Face-to-face interviews were conducted in Hindi/English, per the preference of the participants. The conversations were digitally recorded, transcribed verbatim, and translated to English (where necessary) for analysis. Themes were extracted using inductive coding. Results: A total of 62 adolescents (50% female; 76% private school pupils) with mean age 15.3 (SD: 1.86) years completed the interviews between November 2024 and February 2025. Ten themes emerged including: (i) Perceptions of a snack; (ii) liking for unhealthy snacks; (iii) consequences of snacking; (iv) snacking timing; (v) cost of snacks; (vi) parental rules around snacking; (vii) influence of peers; (viii) school food environment; (ix) neighborhood food environment; (x) food and beverage marketing. Conclusion: These findings show that multiple factors are likely to influence snacking behaviors in Indian adolescents, aligning with literature on adolescent snack consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage healthy snack consumption in adolescents by removing barriers at the individual, household, and societal levels. © © 2025 Rathi, Worsley and Bruening.

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